News Capsules

JANUARY 01, 2009

Patients Find IV Self-Dosing for Pain a Challenge

Recently released research on patients' experiences with controlling their pain themselves with self-dosing intravenous (IV) analgesia reveals that these therapies are 4 times more likely to cause patient harm than other medications.

The findings, published in the December 2008 issue of The Joint Commission Journal on Quality and Patient Safety, show that most mistakes involving IV patient-controlled analgesia (PCA) were a result of human error, equipment problems, or communication breakdowns leading to the patient receiving the wrong dosage or medication.

The study of more than 9500 PCA errors over a 5-year period in the United States showed that patient harm occurred in 6.5% of incidents, compared with 1.5% for general medication errors. The PCA errors also were more severe—harming patients and requiring clinical interventions in response to the error—than other types of medication errors. One case involved a patient who received several 10-mg doses instead of 1-mg medication doses after surgery because of an incorrectly programmed dispensing pump.

"The entire PCA process is highly complex," said the study's lead author, Rodney Hicks, PhD, MSN, MPA, and he called on health care organizations to plan now to make the process safer. Among the strategies he and his coauthors recommend to reduce PCA errors are simplifying the equipment, using bar codes and electronic medication administration records, and involving pharmacists in the design of more easily understood and standardized forms for PCA. For more information on the study, go to

Patients with AD Benefit from Pharmacist Involvement

New research underscores the need for pharmacist involvement in treating patients with Alzheimer's disease (AD). The November/December 2008 issue of the Journal of the American Pharmacists Association featured the article entitled "White Paper on Expanding the Role of Pharmacists in Caring for Individuals with Alzheimer's Disease." The paper presents a summary discussion from a March 2008 meeting convened by the American Pharmacists Association (APhA) Foundation.

Leading national experts met as a coordinating council to discuss the current levels of care and services provided by pharmacies to patients with AD. The council outlined several items that could involve pharmacists in improving care for patients with the disease. Those items include:

  • Identifying and publicizing best practices in collaborative care models
  • Increasing continuing education programs that provide not only clinical insights but information on caregiver issues
  • Evaluating residencies, fellowships, and other certification processes that enhance pharmacist skills
  • Providing overall medication management for patients
  • Provision of medication packaging options that promote patient independence and ease of use for caregivers

"The coordinating council meeting and subsequent white paper highlighted the tremendous need and numerous opportunities for pharmacist involvement in helping patients and families deal with Alzheimer's disease," said William Ellis, executive director of the APhA Foundation. "It is also important to recognize that many patients with Alzheimer's disease also suffer from other chronic conditions where a pharmacist's expertise and skills in medication therapy management can be valuable."

Web Site Offers Resources for Immunizing Pharmacists

The National Community Pharmacists Association (NCPA) is offering a new Immunization Information Resource Center through Pharmacist e-Link. The goal is to provide pharmacists with the tools and information needed to develop and build immunization niche services.

The online center offers practice tools, resources, and education for immunizing pharmacists. Immunization by pharmacists is allowed by law in 49 states. Nearly half of all community pharmacies offer immunizations, according to the 2008 NCPA Digest.

NCPA President Holly Henry, PharmD, said, "From the everyday concerns of a resurgence of mumps, pneumonia, the need for vaccinations for travel abroad to the more global issues of pandemic or greater public health concerns, the independent pharmacy is the ideal center for adult vaccinations and immunizations year round."

Visit Resource for more information.

New Reference Book on Patient Symptoms

Pharmacists looking for a handy reference guide to help patients understand their symptoms may want to check out Merck's first-ever reference book on the subject, The Merck Manual of Patient Symptoms. The paperback is designed to assist pharmacists, nurses, medical students, residents, nurse practitioners, and physician assistants in their growing role on the front line of patient care.

Organized alphabetically, 88 common symptoms—from abdominal pain to wheezing—are addressed in detail. Entries for each symptom begin with a list of possible causes, calling out whenever possible the ones that are more common, more dangerous, or both, followed by suggestive findings. "Red flags" highlight indications of serious health conditions, and treatment guidelines cover common therapies, drugs, and dosages for symptom relief. "The book will make it easier to sort through patients' varied sensations and physical findings and create an effective diagnostic plan," noted Editor Robert Porter, MD.

The Merck Manual of Patient Symptoms complements The Merck Manual of Diagnosis and Therapy, first published in 1899 and now translated into 17 languages. For more information, visit

IRS Delays Debit Card Restrictions in Pharmacies

New health care debit card guidelines from the Internal Revenue Service (IRS) that would have taken effect this month have been delayed until June 1, 2009.

The 6-month delay is to allow more time for compliance with the new rules that add retail pharmacies to the list of merchants required to have an IRS-approved point-of-sale system in place in order to accept a health care debit card. Those rules exclude an exception enabling pharmacies that primarily sell health care items to accept the card as long as they met certain IRS requirements.

TV Star Goes "Behind-the-Counter" to Promote Pharmacy

Comedian Brad Sherwood is the face of the Behind-the-Counter Encounters educational campaign. The campaign, launched by the American Pharmacists Association (APhA) and supported by McNeil Consumer Healthcare, combines educational content and wit to shed light on the vital role that pharmacists play in health care.

As part of the program, Sherwood stars with pharmacists in an entertaining series of online vignettes that portray a "day in the life" of a pharmacist, based on real-life pharmacists' experience. An APhA survey of 1719 individuals found that 68% of individuals do not even know their pharmacist's name, but when they asked their pharmacist a question, 99% received the help they needed.

For more information on the campaign, visit